Bare bones truth
Your Health - Dr. Gita Mathai
We take our bones for granted, even though without them we would be masses of protoplasm wobbling along like amoebae. Bones help us to maintain our form, figure, balance and locomotion. If we do not take care then our bones weaken with age. Posture and balance are affected and eventually falls and fractures occur. In India, in the population over the age of 60, 50 per cent have fallen in the last six months and 25 per cent of these falls have resulted in fractures.
In the previous era, fractures were not as frequent. The life expectancy was around 40, so death was more likely than a fracture. Pan chewing was rampant. The lime in the pan provided bone-strengthening calcium. People walked for long distances in the sun, receiving vitamin D and developing strong bones. Many practised yoga.
Yoga actually places pressure on the bone. As it is practised, agonistic and antagonistic muscles pull against each other. This strengthens the bones. As a bonus, posture, balance, coordination, the range of motion, flexibility and gait improve. This reduces the chances of falls and fractures.
The nine yoga poses (English names) found to be most helpful are tree, triangle, warrior II, side-angle, twisted triangle, eagle, locust, bridge, straight-legged twist, and bent-knee twist.
Calcium is needed for strong bones. The requirements are 800 milligram (mg) a day from ages 4-8 and 1300mg a day after the age of nine. Calcium is absorbed and utilised when sufficient concentrations of the "sunshine vitamin" D is available. Children from one to 18 need 800 International Units (IU) of vitamin D daily. Adults require 1000-1200 IU daily. Very few people expose their skin to sufficient sunshine to get this amount naturally.
Just consuming the recommended amount of calcium and vitamin D is not enough. Stress has to be placed on the bones for the calcium to enter the matrix. Weight bearing and muscle strengthening activities have to be performed regularly. Walking, running, jogging, stair climbing, dancing, or sports such as basketball, tennis and badminton are excellent. Swimming improves overall fitness, but does not improve bone strength.
If you are strapped for time, the most efficient exercise for bones is 40 jumps overall, or 20 hops on each leg. This will also help coordination and balance. Please make sure that you wear supportive footwear.
The maximum bone development occurs in childhood and adolescence. It is important that children and teenagers spend an hour a day doing physical activity to balance time spent in front of the computer or television. If their diet is inadequate in calcium and vitamin D, supplements can be given. Poor bone development at this crucial stage in life will result in diminished bone density, early bone loss and increased risk of fractures in later life.
The risk of osteoporosis is increased:
• In older persons, particularly women
• In both sexes if they are inactive
• If you have a BMI (weight divided by height in metre squared) less than 19
• If there is a history of osteoporosis and fractures in the family
• If you smoke or are exposed to second hand smoke
• If you have more than two pegs of alcohol a day
• If you are on steroid medications
• If you have had gastric or weight loss surgery
• If you suffer from Coeliac disease or Crohn's disease
Many of these factors cannot be avoided, but you can lessen their impact with regular exercise and calcium and vitamin D supplements.
Dr Gita Mathai is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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